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The Framingham Heart Study

Craig R. Walsh, MD; Martin G. Larson, ScD; Eric P. Leip, MS; Ramachandran S. Vasan, MD, DM; Daniel Levy, MD

Arch Intern Med. 2002;162:1007-1012.

Background  Published studies of the association between serum potassium concentration and risk for cardiovascular disease in community-based populations have reported conflicting results. We sought to determine the association between serum potassium concentration and cardiovascular disease risk in the Framingham Heart Study.

Methods  A total of 3151 participants (mean age, 43 years; 48% men) in the Framingham Heart Study who were free of cardiovascular disease and not taking medications affecting potassium homeostasis had serum potassium levels measured (1979-1983). Proportional hazards models were used to determine the association of serum potassium concentration at baseline with the incidence of cardiovascular disease at follow-up.

Results  During mean follow-up of 16 years, 313 cardiovascular disease events occurred, including 46 cardiovascular disease–related deaths. After adjustment for age, serum potassium level was marginally associated with risk of cardiovascular disease (hazard ratio [HR] per 1 mg/dL increment, 1.03; 95% confidence interval [CI], 1.00-1.05; P = .02). However, after further adjustment for multiple confounders, serum potassium level was not significantly associated with cardiovascular disease risk (HR, 1.00; 95% CI, 0.98-1.03). There were no significant associations between serum potassium level and cardiovascular disease–related death in either age- and sex-adjusted models (HR, 1.06; 95% CI, 0.99-1.12) or multivariable-adjusted models (HR, 1.04; 95% CI, 0.97-1.11).

Conclusion  In our community-based sample of individuals free of cardiovascular disease and not taking medications that affect potassium homeostasis, serum potassium level was not associated with risk of cardiovascular disease.

From the National Heart, Lung, and Blood Institute's Framingham Heart Study, National Institutes of Health, Framingham, Mass (Drs Walsh, Larson, Vasan, and Levy and Mr Leip); the Cardiology Division, Department of Medicine, Massachusetts General Hospital (Dr Walsh), and the Department of Medicine, Beth Israel–Deaconess Medical Center (Dr Levy), Harvard Medical School, Boston; and the Section of Epidemiology and Preventive Medicine, Evans Department of Medicine, Boston University School of Medicine (Drs Larson, Vasan, and Levy and Mr Leip).

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